NPIMap

Individual provider Active NPI

Michael Shaoyi Fang, M.D.

  • Nephrology Physician
  • Downey, CA
National Provider Identifier
1154338580
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
A88548 Issued in CA
Practice address
11480 Brookshire Ave
Ste 302
Downey, CA 90241-5024
Phone
(626) 337-2265
Fax
(626) 337-6625
NPI assigned
Aug 1, 2006
Last updated
Oct 1, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 222907 NY
Nephrology Physician 207RN0300X A88548 CA Primary

Addresses

Primary practice location

11480 Brookshire Ave
Ste 302
Downey, CA 90241-5024

Mailing address

3129 S Hacienda Blvd
Ste 159
Hacienda Heights, CA 91745-6304
Phone (626) 262-3317

Other identifiers 1

IdentifierTypeStateIssuer
00A885480MedicaidCA

Other names 1

  • Shaoyi Fang Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050719000454 CA Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Nephrology 9537137963 Practice locations: Downey, CA

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Other, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11480 Brookshire Ave
Suite 302
Downey, CA 90241-5024
Phone (562) 862-0804

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
222907NYMDLicensed Practical Nurse
A88548CAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newyork-Presbyterian/Queens Past Accepting new patients
Nephrology Associates, P.C. Nephrology Past Accepting new patients
Caduceus Physicians Medical Group Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients
Nephrology Associates,P.C. Nephrology Past Accepting new patients

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538352000000",
    "number": "1154338580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3129 S HACIENDA BLVD",
            "address_2": "STE 159",
            "city": "HACIENDA HEIGHTS",
            "state": "CA",
            "postal_code": "917456304",
            "telephone_number": "626-262-3317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11480 BROOKSHIRE AVE",
            "address_2": "STE 302",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902415024",
            "telephone_number": "626-337-2265",
            "fax_number": "626-337-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANG",
        "first_name": "MICHAEL",
        "middle_name": "SHAOYI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2018-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NY",
            "license": "222907",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A88548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A885480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAOYI",
            "last_name": "FANG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Downey, CA

Sources for this page

Verify at the official NPI Registry.